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High prevalence of subclinical atherosclerosis in Brazilian postmenopausal women with low and intermediate risk by Framingham score

  • Ana Claudia Gomes Pereira Petisco
  • Jorge Eduardo Assef
  • Carlos Alberto de Jesus
  • Mohamed Hassan Saleh
  • Jose Eduardo Martins Barbosa
  • David Costa de Souza Le Bihan
  • Ibraim Masciarelli França Pinto
  • Simone Rolim Fernandes Fontes Pedra
  • Rodrigo Bellio de Mattos Barretto
  • Amanda Guerra de Moraes Rego Sousa
Original Paper

Abstract

Cardiovascular diseases are the leading cause of mortality among women in several countries. Early detection of subclinical atherosclerosis (SA) could enable the adoption of preventive measures to avoid cardiovascular events. This study aimed to determine the prevalence of SA in Brazilian asymptomatic postmenopausal women in Framingham Risk Score (FRS) low and intermediate groups. Computed tomography (CT) and ultrasound (US) scans were performed in 138 asymptomatic postmenopausal women (56.1 ± 4.9 years of age) to survey for coronary artery and aortic calcification (CT scan) and assess carotid intima-media thickness (CIMT) and identify carotid plaques (US). The mean FRS was 2.64 ± 2.13 %. The prevalence of increased CIMT, carotid plaques, increased CIMT and/or plaques, coronary artery calcification (CAC) >0 and aortic calcification (AC) were, respectively, 45.7, 37.7, 62.3, 23.9 and 45.7 %. Normal imaging tests were found in 22.4 %. SA, defined as at least one abnormal imaging test, was associated with age, FRS, waist-to-rip ratio, systolic and diastolic blood pressure, HDL-c and ApoA1 levels, and ApoA1/ApoB ratio. In logistic regression, SA was associated with higher age (OR 1.108, 95 % CI 1.010–1.215, p = 0.029) and lower ApoA1 levels (OR 0.979, 95 % CI 0.960–0.998, p = 0.029). SA was prevalent in Brazilian postmenopausal women with low and intermediate risk groups (FRS) and was associated with higher age and lower levels of ApoA1. Carotid atherosclerosis was the most common presentation of SA in this group.

Keywords

Atherosclerosis Cardiovascular diseases Imaging Menopause Risk assessment 

Abbreviations

AC

Aortic calcification

AMORIS

Apolipoprotein-Related Mortality Risk Study

ASE

American Society of Echocardiography

ATPIII

Adult Treatment Panel III

BMI

Body mass index

CAC

Coronary artery calcification

CAD

Coronary artery disease

CIMT

Carotid intima-media thickness

CVD

Cardiovascular diseases

FRS

Framingham Risk Score

NCEP

National Cholesterol Education Program

SA

Subclinical atherosclerosis

YSM

Years since menopause

Notes

Acknowledgments

The authors would like to thank the echocardiography and computer tomography staff and personnel for the continuous support during the course of this study.

Compliance with ethical standards

Conflict of interest

This research was developed according to ethical standards statements and authors declare no conflict of interests related to the content of this manuscript.

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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Ana Claudia Gomes Pereira Petisco
    • 1
  • Jorge Eduardo Assef
    • 1
  • Carlos Alberto de Jesus
    • 1
  • Mohamed Hassan Saleh
    • 1
  • Jose Eduardo Martins Barbosa
    • 1
  • David Costa de Souza Le Bihan
    • 1
  • Ibraim Masciarelli França Pinto
    • 1
  • Simone Rolim Fernandes Fontes Pedra
    • 1
  • Rodrigo Bellio de Mattos Barretto
    • 1
  • Amanda Guerra de Moraes Rego Sousa
    • 1
  1. 1.Instituto Dante Pazzanese de CardiologiaSão PauloBrazil

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